{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:39:07Z","timestamp":1787071147868,"version":"build-2736575974"},"reference-count":10,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T00:00:00Z","timestamp":1738627200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:p>Patients with neurofibromatosis undergo multiple surgeries during their lifetime, presenting as challenging scenarios to the perioperative team. We present the case report of a young male patient with type 1 neurofibromatosis scheduled for endovascular embolization of thoracic spinal arteriovenous malformation under general anesthesia. Associated vasculopathy included stented descending thoracic aortic coarctation, an unrepaired saccular aortic aneurysm (AA) distal to the stent suggestive of a type 1 endoleak, bilateral segmental pulmonary arterial thrombosis, bilateral subclavian artery stenosis, and a retroperitoneal neurofibroma compressing the coeliac artery. Our primary concerns were a possible periprocedural AA rupture becoming a surgical emergency, difficult vascular access, and perioperative thromboembolism. Periprocedural hemodynamic surges were avoided using continuous hemodynamic monitoring, adequate anesthetic depth, and analgesia. After an uneventful procedure, the patient was extubated with a smooth postoperative course. An in-depth knowledge about underlying pathophysiology, anticipation and preparedness for potential complications, and interdisciplinary coordinated teamwork serve to preserve patient outcomes.<\/jats:p>","DOI":"10.4103\/bc.bc_76_24","type":"journal-article","created":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T05:00:21Z","timestamp":1738645221000},"page":"162-165","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Anesthetic management of endovascular embolization in a patient of neurofibromatosis with associated aortic and multisystemic vasculopathy: A case report"],"prefix":"10.4103","volume":"11","author":[{"given":"Sangeetha R.","family":"Palaniswamy","sequence":"first","affiliation":[{"name":"Department of Neuroanaesthesia and Neurocritical Care, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meshwa","family":"Desai","sequence":"additional","affiliation":[{"name":"Department of Neuroanaesthesia and Neurocritical Care, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ankit","family":"Arora","sequence":"additional","affiliation":[{"name":"Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. R.","family":"Aravinda","sequence":"additional","affiliation":[{"name":"Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,2,4]]},"reference":[{"key":"R1-20260422","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.1007\/s12630-015-0414-z","article-title":"Airway neurofibroma","volume":"62","author":"Sriganesh","year":"2015","journal-title":"Can J Anaesth"},{"key":"R2-20260422","doi-asserted-by":"crossref","first-page":"3009","DOI":"10.1002\/ajmg.a.62931","article-title":"Neurovascular complications in adults with neurofibromatosis type 1: A national referral center experience","volume":"188","author":"Sheerin","year":"2022","journal-title":"Am J Med Genet A"},{"key":"R3-20260422","doi-asserted-by":"crossref","first-page":"S71","DOI":"10.21037\/cdt.2017.09.14","article-title":"Syndromes with aortic involvement: Pictorial review","volume":"8","author":"Zucker","year":"2018","journal-title":"Cardiovasc Diagn Ther"},{"key":"R4-20260422","doi-asserted-by":"crossref","first-page":"204","DOI":"10.5001\/omj.2013.55","article-title":"Coarctation of the aorta, known yet can be missed","volume":"28","author":"Al Balushi","year":"2013","journal-title":"Oman Med J"},{"key":"R5-20260422","first-page":"367","article-title":"Coarctation of aorta and post-stenotic dissecting aortic aneurysm successfully treated with endovascular stent","volume":"13","author":"Jata","year":"2020","journal-title":"Int Med Case Rep J"},{"key":"R6-20260422","doi-asserted-by":"crossref","first-page":"399","DOI":"10.14503\/THIJ-16-6093","article-title":"Endovascular treatment of distal aortic arch aneurysm associated with coarctation of aorta in a Jehovah\u2019s witness","volume":"44","author":"Di Tommaso","year":"2017","journal-title":"Tex Heart Inst J"},{"key":"R7-20260422","doi-asserted-by":"crossref","first-page":"13.","DOI":"10.1186\/s43044-020-00051-7","article-title":"Successful thoracic endovascular aortic repair for post-coarctoplasty aneurysm","volume":"72","author":"Saedi","year":"2020","journal-title":"Egypt Heart J"},{"key":"R8-20260422","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1055\/s-0029-1208381","article-title":"Management of endoleaks following endovascular aneurysm repair","volume":"26","author":"White","year":"2009","journal-title":"Semin Intervent Radiol"},{"key":"R9-20260422","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/j.bjae.2019.01.004","article-title":"Perioperative management of thoracic and thoracoabdominal aneurysms","volume":"19","author":"Agarwal","year":"2019","journal-title":"BJA Educ"},{"key":"R10-20260422","doi-asserted-by":"crossref","first-page":"68.","DOI":"10.1186\/s12968-019-0578-8","article-title":"Repaired coarctation of the aorta, persistent arterial hypertension and the selfish brain","volume":"21","author":"Rodrigues","year":"2019","journal-title":"J Cardiovasc Magn Reson"}],"container-title":["Brain Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/bc.bc_76_24","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:42:12Z","timestamp":1787067732000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/bc.bc_76_24"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,4]]},"references-count":10,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/bc.bc_76_24","relation":{},"ISSN":["2394-8108","2455-4626"],"issn-type":[{"value":"2394-8108","type":"print"},{"value":"2455-4626","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,4]]},"assertion":[{"value":"2024-07-25","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-11","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}